Screening for Dementia

Edit 0 1 …
Topics in Geriatrics: Dementia Screening

Dementia screening tools are used to decipher if someone has normal age related memory problems or more severe type of memory problems.

Objectives:
The objectives of this page are to:

1 Learn more about dementia screening tools
2 Learn how to administer dementia screening tests
3 Learn how assessments are scored and cut off criteria
4 Learn the validity of the tests
5 Learn what test to choose for different populations

Screening Tools

The Abbreviated Mental Test Score (AMTS)
GOLD STANDARD FOR CLINICAL DIAGNOSIS
10 items scored with either a 0 or 1.
0= didn’t answer question correctly 1= correct answer
  • Assess orientation, registration, recall and concentration
  • Any clinician is able to administer test
  • Takes approximately 3-4 min to complete
  • Available on mobile application

Scoring
Max score =10
> 6 = Normal
4-6 = Moderate impairment
0-3 = Severe impairment
Validity
Specificity: .95
Sensitivity: .79
* Low positive predicative value, need second assessment to confirm diagnosis

Link to AMTS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2560932/pdf/occpaper00113-0035.pdf

Clock Drawing Test
Assesses visuo-spatial deficits- early sign of dementia
  • Evaluates a small area of the cognitive realm related to dementia; many other conditions may affect testing (stroke)

There are different ways to administer the test. One way to administer test:
  • Patient given paper with circle on it
  • Orient patient to top of page
  • Ask to draw numbers on the clock
  • Ask to draw hour and min hands for it to read “10 after 11”

Scoring
Max Score= 6
≥ 3 = cognitive deficit
1-2 = normal

Validity
Specificity: .96
Sensitivity: .86

Link to Clock Drawing Test
**https://www.healthcare.uiowa.edu/igec/tools/cognitive/clockDrawing.pdf**

Montreal Cognitive Assessment
Screens for mild cognitive impairment (MCI) and vascular dementia
  • Assesses attention, concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations and orientation
  • Takes 10 min to administer
  • More sensitive than MMSE

Scoring
Max Score: 30
>26 = normal
1-25 = impaired

Validity
Specificity: .90 - .96
Sensitivity: .87

Link to Montreal Cognitive Assessment
**http://www.mocatest.org**

Mini Mental State Examination (MMSE)
Brief screening tool NOT diagnostic tool
Should be used to document changes over time
  • More valid the increased severity of the cognitive impairment
  • Assesses orientation, memory, attention, calculation, language and visual construction
  • Widely used tool throughout the world
  • Scored impacted by age, education, cultural background

Scoring
Max Score: 30
<24 = normal
1-23 = impaired

Validity
Specificity: .91
Sensitivity: .69
http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.1992.tb01992.x/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+on+11th+July+2015+at+10%3A00-16%3A00+BST+%2F+05%3A00-11%3A00+EDT+%2F+17%3A00-23%3A00++SGT++for+essential+maintenance.++Apologies+for+the+inconvenience&userIsAuthenticated=false&deniedAccessCustomisedMessage=

Link to MMSE
**http://www.mountsinai.on.ca/care/psych/on-call-resources/on-call-resources/mmse.pdf**





References:

1. **http://ageing.oxfordjournals.org/content/27/3/399.full.pdf**
2. **http://www.ncbi.nlm.nih.gov/pubmed/17542384**
3.**http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8747599&fileId=S135561771200077X**
4.**http://consultgerirn.org/uploads/File/trythis/try_this_3_2.pdf**
5. **http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2587038/**
6. **http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487532/**